Impact of academic interventions on students performance in electives

Background: Elective clinical rotations have become a significant part of most of the medical educational curricula. Evaluation of electives is imperative to assess their usefulness in achieving the objective of improving the competencies of graduating students. Results of these evaluations can be used to guide future academic developments

Objective: The purpose of this study was to assess the change in the performance of medical students after academic intervention based on the results of evaluation of previous year electives

Methods: Students' performances in elective rotations were evaluated in the year 2012 and again in 2013 after bringing modifications in teaching / learning program. The data collected was from 60 students. Students consisted of two sets, those who completed their electives in the country while the other completed their electives abroad. Scores were calculated in three distinct domains of education i.e knowledge, attitude and ethical behavior. Independent Sample T test was applied to compare the scores

Results: Findings suggest that as a result of the academic interventions carried out in 2013 in the educational program by the combined efforts of the faculty and students, the scores for all the three educational domains in both the local and abroad groups improved considerably

Conclusion: Study findings conclude that active curricular interventions play important role in improving the outcomes of teaching programs

Effect of buctril super (Bromoxynil) herbicide on soil microbial biomass and bacterial population

The present study aimed to evaluate the effect of bromoxynil herbicide on soil microorganisms, with the hypothesis that this herbicide caused suppression in microbial activity and biomass by exerting toxic effect on them. Nine sites of Punjab province (Pakistan) those had been exposed to bromoxynil herbicide for about last ten years designated as soil 'A' were surveyed in 2011 and samples were collected and analyzed for Microbial Biomass Carbon (MBC), Biomass Nitrogen (MBN), Biomass Phosphorus (MBP) and bacterial population. Simultaneously, soil samples from the same areas those were not exposed to herbicide designated as soil 'B' were taken. At all the sites MBC, MBN and MBP ranged from 131 to 457, 1.22 to 13.1 and 0.59 to 3.70 µg g-1 in the contaminated soils (Soil A), which was 187 to 573, 1.70 to 14.4 and 0.72 to 4.12 µg g-1 in the soils without contamination (soil B). Bacterial population ranged from 0.67 to 1.84x10(8) and 0.87 to 2.37x10(8) cfu g-1 soil in the soils A and B, respectively. Bromoxynil residues ranged from 0.09 to 0.24 mg kg-1 at all the sites in soil A. But no residues were detected in the soil B. Due to lethal effect of bromoxynil residues on the above parameters, considerable decline in these parameters was observed in the contaminated soils. Results depicted that the herbicide had left toxic effects on soil microbial parameters, thus confirmed that continuous use of this herbicide affected the quality of soil and sustainable crop production.

Facial nerve morbidity following surgery for benign parotid tumours

To determine the frequency and severity of facial nerve dysfunction following surgery for benign parotid gland tumours. A case series. ENT Department, Karachi Medical and Dental College and Abbasi Shaheed Hospital and Ziauddin University Hospital, from 1990 to 2010. Data was collected of all patients who were surgically managed for benign parotid tumours from 1990 to 2010. Data was reviewed for presentation of tumour, age and gender of the patient, site of tumour, nature and morphology of the tumour, primary or recurrent, surgical procedure adopted and the complications of the surgery especially the facial nerve dysfunction, its severity, complete or partial paresis and transient or permanent and time of recovery. Results were described as frequency percentages. Out of 235 patients, 159 [67.65%] were female and 76 [32.35%] were male. Age ranged from 18 to 70 years. Pleomorphic adenoma was the most common tumour [n=194, 82.6%], followed by Warthin's tumour. Superficial parotidectomy was done in 188 cases and extended parotidectomy in 47 cases. In the immediate postoperative period facial nerve function was normal in 169 [72%] patients and nerve dysfunction was observed in 66 [28%] patients. Complete paresis involving all the branches of facial nerve was seen in 25 [10.6%] patients and 41 [17.4%] patients were having incomplete dysfunction. Of these, 62 [26.3%] recovered and 04 [1.7%] had permanent facial nerve dysfunction. Marginal mandibular branch of facial nerve was involved in 57 [86.3%] cases. The frequency of temporary and permanent facial nerve dysfunction was 26.3% and 1.7% respectively in 235 consecutive parotidectomies for benign parotid gland tumours. Higher frequency of facial nerve dysfunction was found in recurrent and deep lobe tumours

Clinical profile of patients with presenting hoarseness

To describe the causes of voice disorder [hoarseness] among general population attending E.N.T department in Abbasi Shaheed Hospital. It is the descriptive study of 100 patients, who enrolled from out patient department and admitted in E.N.T department of Abbasi Shaheed Hospital. The data was collected as per the specially designed Performa. This study was done in Abbasi Shaheed Hospital, Karachi. Most of the patient with hoarseness 38 [38%] were observed between 5-15 years followed by 16-24 years old 26 [26%] patients. The most common cause of hoarseness was vocal cord nodules 35 patients [35%] followed by acute laryngitis, 22 patients [22%] and chronic non specific laryngitis 14 patients [14%]. Hoarseness due to carcinoma of larynx, 13 patients [13%]

Morphological pattern of parotid gland tumors

To determine the morphological pattern of parotid tumours. Case series. ENT Department of Karachi Medical and Dental College and Abbasi Shaheed Hospital, Karachi, from 1990 to 2004. During this study, 204 patients with parotid tumours were registered. The patients of all ages and both gender were included in this study. All patients were evaluated by history, clinical examination, F.N.A.C. and ultrasound, C.T/MRI was done in selected cases. All patients were surgically managed and their tumour specimen was sent for histopathology. Classification of individual tumour was based on 1991 World Health Organization Classification. Discrete data was presented in percentage and proportions. Out of 204 cases, 152 [74.5%] were benign and 52 [25.5%] were malignant. Of these, 117 [57.35%] patients were females and 87 [42.65%] males. Benign tumours were more common in females whereas malignant tumours were common in males. The mean age of patients was 34 years and 42 years for benign and malignant tumours respectively. Pleomorphic adenoma was most common benign tumor [83.5%], followed by Warthins tumour. The most common malignant tumour was mucoepidermoid carcinoma [60%], followed by adenoid cystic carcinoma. Superficial lobe of parotid gland was the commonest site, 120 benign and all 52 malignant tumours arising from it while 32 benign tumours originated from deep lobe. Parotid swelling for years was main feature of benign tumours, whereas malignant tumours presented with pain, fixation to skin or underlying structure, cervical lymphadenopathy and facial palsy. Pleomorphic adenoma was the most common benign tumour and mucoepidermoid carcinoma was most common malignant tumour. The morphological patterns and distribution followed the known pattern

Surgical management of CSOM in a Tertiary Medical Centre

To determine the surgical outcome of chronic suppurative otitis media [CSOM] in term of anatomical and functional results. This study was conducted in the department of E.N.T. Abbasi Shaheed Hospital, Karachi, over a period of one year from Jan 2002 to Jan 2003. 50 consecutive patients were included in this study presented with chronic suppurative otitis media. All cases were enrolled in previously prepared performa which include pertinent clinical history and examination, results of related investigations, surgical findings, surgical techniques adopted and final out come. Total 50 patients were included in this study, of which 23 were male and 27 female with the ages from 2 years to 53 years. Surgical techniques included the intact canal tympanoplasty in 15[30%] patients and canal wall down tympanoplasty in 20[40%] patients. In the canal wall down technique, cavity problems were observed in 3 [8.5%] patients. Graft takes were good in 33 [94%] patients and functional results in term of gain in hearing were observed in 31 [88.5%] cases. CSOM may associate in some farm of irreversible sequelae or pathological condition of the middle ear. It is the disease of low socioeconomic group. The infection may be mixed and polymicrobial, however complications are rare because of the invention of effective antimicrobial agents. Anatomical and functional results were good in our series and this is due to good pre-operative assessment, use of proper surgical techniques and long term follow up

Micropathogens in chronic suppurative otitis media an experience of 208 pus cultures at Abbasi Shaheed Hospital

To determine the causative pathogens of chronic suppurative otitis media and their antimicrobial sensitivity. Prospective analytic study. Two hundreds patients were enrolled for the study attending the ENT out patient department of Karachi Medical and Dental College and Abbasi Shaheed Hospital. Majority of the patients were children and young adult, with male predilection. 208 Pus cultures were taken from the ears of the 175 selected patients and Gram staining and antibiotic sensitivity was done on all of them. Staphlococcus aureus and Pseudomonas aeruginosa were responsible for most of infections in this study about 68%. Proteus spp., Klebsiella spp. and E.coli were also found in the cultures but in very low figure. Quinolones and aminoglycosides were found extremely effective against the two major pathogens, i.e., Staph.aureus and Pseudomonas aeruginosa with sensitivity index of 91% and 98% respectively. Macrolides and cephalosporins were also highly effective with 80-88% sensitivity whereas both Staph.aureue and Pseudomonas were quite resistant to Ampicillin and Amoxicillin. Chronic suppurative otitis media is primarily the disease of children and young adults, and incidence in adult and old population being very less. Staphylococcus aureus and Pseudomonas aeruginosa are most frequent causative organism and extremely sensitive to quinolones and aminoglycosides

Fine needle aspiration cytology

Fine Needle Aspiration Cytology [FNAC] is a diagnostic modality, which over the years has proved itself to be quick and virtually without complications. Since its popularization in late 1920's by Martin and Ellis, it has undergone a tortuous course, comprising popularity, ignorance and again a period of well-acceptance. This time, however, its use has also initiated exploration into new vistas in the form of study of biological behaviour of tumour cells and detection of different receptors and tumour markers etc. Initially employed cautiously and limitedly, FNAC, now-a-days is being applied to almost all the superficial and deep structures of the body, both in children as well as in the adults. Also synergistic [additional] advantage is being gained with C.T. scan, MRI, Ultrasound, endoscopy and various immunological techniques to broaden the utility of this modality in different diagnostic and prognostic horizons

Fine needle aspiration cytology in parotid lumps

Over a period of two years, Fine Needle Aspiration Cytology [FNAC] was performed on 33 patients presenting with a parotid lump. Five patients were excluded as they were treated medically after FNAC report. The FNAC results of 28 cases were compared with histopathological diagnoses of surgically resected specimens. There were 8 true positive, 17 true negative, 1 false positive and 2 false negative cases. Sensitivity was 80%, specificity 94.4% and diagnostic accuracy 89.3%. FNAC is a simple quick, accurate and virtually complications free investigative modality. It is also helpful adjunct to assess preoperatively the suitability and extent of the surgical treatment